PMID- 29934436
OWN - NLM
STAT- MEDLINE
DCOM- 20190426
LR  - 20190426
IS  - 1468-3288 (Electronic)
IS  - 0017-5749 (Linking)
VI  - 68
IP  - 5
DP  - 2019 May
TI  - Incidence of faecal occult blood test interval cancers in population-based
      colorectal cancer screening: a systematic review and meta-analysis.
PG  - 873-881
LID - 10.1136/gutjnl-2017-315340 [doi]
AB  - OBJECTIVE: Faecal immunochemical tests (FITs) are replacing guaiac faecal occult 
      blood tests (gFOBTs) for colorectal cancer (CRC) screening. Incidence of interval
      colorectal cancer (iCRC) following a negative stool test result is not yet known.
      We aimed to compare incidence of iCRC following a negative FIT or gFOBT. DESIGN: 
      We searched Ovid Medline, Embase, Cochrane Library, Science Citation Index,
      PubMed and Google Scholar from inception to 12 December 2017 for citations
      related to CRC screening based on stool tests. We included studies on FIT or
      gFOBT iCRC in average-risk screening populations. Main outcome was pooled
      incidence rate of iCRCs per 100 000 person-years (p-y). Pooled incidence rates
      were obtained by fitting random-effect Poisson regression models. RESULTS: We
      identified 7 426 records and included 29 studies. Meta-analyses comprised data of
      6 987 825 subjects with a negative test result, in whom 11 932 screen-detected
      CRCs and 5 548 gFOBT or FIT iCRCs were documented. Median faecal haemoglobin (Hb)
      positivity cut-off used was 20 (range 10-200) microg Hb/g faeces in the 17
      studies that provided FIT results. Pooled incidence rates of iCRC following FIT
      and gFOBT were 20 (95% CI 14 to 29; I(2)=99%) and 34 (95% CI 20 to 57; I(2)=99%) 
      per 100 000 p-y, respectively. Pooled incidence rate ratio of FIT versus gFOBT
      iCRC was 0.58 (95% CI 0.32 to 1.07; I(2)=99%) and 0.36 (95% CI 0.17 to 0.75;
      I(2)=10%) in sensitivity analysis. For every FIT iCRC, 2.6 screen-detected CRCs
      were found (ratio 1:2.6); for gFOBT, the ratio between iCRC and screen-detected
      CRC was 1:1.2. Age below 60 years and the third screening round were
      significantly associated with a lower iCRC rate. CONCLUSION: A negative gFOBT
      result is associated with a higher iCRC incidence than a negative FIT. This
      supports the use of FIT over gFOBT as CRC screening tool.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text
      of the article) 2019. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Wieten, Els
AU  - Wieten E
AUID- ORCID: 0000-0003-4324-9124
AD  - Department of Gastroenterology and Hepatology, Erasmus MC University Medical
      Center, Rotterdam, The Netherlands.
FAU - Schreuders, Eline H
AU  - Schreuders EH
AUID- ORCID: 0000-0001-5103-4022
AD  - Department of Gastroenterology and Hepatology, Erasmus MC University Medical
      Center, Rotterdam, The Netherlands.
FAU - Grobbee, Esmee J
AU  - Grobbee EJ
AD  - Department of Gastroenterology and Hepatology, Erasmus MC University Medical
      Center, Rotterdam, The Netherlands.
FAU - Nieboer, Daan
AU  - Nieboer D
AD  - Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The
      Netherlands.
FAU - Bramer, Wichor M
AU  - Bramer WM
AD  - Medical Library, Erasmus University Medical Center Rotterdam, Rotterdam, The
      Netherlands.
FAU - Lansdorp-Vogelaar, Iris
AU  - Lansdorp-Vogelaar I
AD  - Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The
      Netherlands.
FAU - Bruno, Marco J
AU  - Bruno MJ
AD  - Department of Gastroenterology and Hepatology, Erasmus MC University Medical
      Center, Rotterdam, The Netherlands.
FAU - Kuipers, Ernst J
AU  - Kuipers EJ
AD  - Department of Gastroenterology and Hepatology, Erasmus MC University Medical
      Center, Rotterdam, The Netherlands.
FAU - Spaander, Manon C W
AU  - Spaander MCW
AD  - Department of Gastroenterology and Hepatology, Erasmus MC University Medical
      Center, Rotterdam, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20180622
PL  - England
TA  - Gut
JT  - Gut
JID - 2985108R
SB  - AIM
SB  - IM
MH  - Colorectal Neoplasms/*diagnosis/epidemiology
MH  - Early Detection of Cancer
MH  - Humans
MH  - Incidence
MH  - *Occult Blood
OTO - NOTNLM
OT  - *colorectal cancer screening
OT  - *epidemiology
OT  - *meta-analysis
COIS- Competing interests: None declared.
EDAT- 2018/06/24 06:00
MHDA- 2019/04/27 06:00
CRDT- 2018/06/24 06:00
PHST- 2017/10/15 00:00 [received]
PHST- 2018/05/11 00:00 [revised]
PHST- 2018/05/23 00:00 [accepted]
PHST- 2018/06/24 06:00 [pubmed]
PHST- 2019/04/27 06:00 [medline]
PHST- 2018/06/24 06:00 [entrez]
AID - gutjnl-2017-315340 [pii]
AID - 10.1136/gutjnl-2017-315340 [doi]
PST - ppublish
SO  - Gut. 2019 May;68(5):873-881. doi: 10.1136/gutjnl-2017-315340. Epub 2018 Jun 22.